Chondroitin sulfate superior to celecoxib for knee cartilage loss

In patients with knee osteoarthritis, quantitative MRI found chondroitin sulfate was superior to celecoxib in the reduction of cartilage volume loss, according to results of a 2-year exploratory study.

Pelletier and colleagues performed quantitative MRI (qMRI) at baseline, 12 months and 24 months to evaluate bone marrow lesion size and synovial thickness in patients with knee OA. Afterward, the researchers performed analyses of modified intention-to-treat (mITT) (n = 138) and according-to-protocol (ATP) (n = 120) populations. The primary endpoint was the qMRI cartilage volume loss (CVS) in the lateral compartment due to 1,200 mg of daily chondroitin sulfate (CS) compared with 200 mg of daily celecoxib. The secondary endpoints were the assessment of OA structural changes, as well as signs and symptoms of OA.

In the mITT analysis, patients treated with CS after 24 months — compared with patients treated with celecoxib — had significantly reduced CVS in the medial compartment (–8.1% vs. –6.3%) and in the medial condyle (–7.7% vs. –5.5%), but not in the lateral compartment. In the ATP analysis, they found patients treated with CS had significantly reduced CVS in the medial compartment at 12 months (–5.6% vs. –4.5%) and at 24 months (–8.4% vs. –6.6%), as well as in the medial condyle at 24 months (–8.1% vs. –5.7%).

In patients with CS, the researchers observed an upward trend toward reduced synovial thickness in the medial suprapatellar bursa. They also observed a reduced incidence of joint swelling, effusion and overall symptoms with time in both groups. Further, both groups showed good safety profiles including cardiovascular events.